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How a DRG is Built: A Payor’s Perspective

Presenter Amarin Alexander MD MBA MA, CPC-A, CDEI, CIC, CPMA, CRC
Broadcast Date 10/9/2024
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
How a DRG is Built: A Payor’s Perspective Webinar

Learn more about this event

Join us for an insightful webinar that explores the Diagnosis-Related Group (DRG) system of inpatient hospital reimbursement in the U.S. We will provide a comprehensive overview of DRG structures and delve into the crucial role of ICD-10-CM and PCS codes in shaping DRG compositions.

Key topics will include:
-An overview of DRG structures and their significance in hospital reimbursement.
-An examination of the ICD-10-CM Official Guidelines for Coding and Reporting, along with PCS Guidelines.
-A discussion on the implications of including or excluding specific codes and how these decisions impact reimbursement outcomes.

Don’t miss this opportunity to deepen your understanding of the DRG system and enhance your coding expertise!

Learning Objectives/Agenda

• The definition of a DRG
• To demonstrate why DRGs are important in the U.S.
• To illustrate how DRGs are constructed
• To define important considerations when composing a DRG
• To highlight certain ICD-10 CM and PCS guidelines that impact DRG composition.

Why is this topic important?

The DRG system is the main mechanism for short-term acute care hospital reimbursement in the U.S. Correct DRG composition ensures accurate reimbursement and population health data composition.

Who would benefit from this topic?

• Hospital Coders
• Hospital Coding Auditors
• Physician Advisors
• Fraud, Waste, and Abuse Auditors
• Hospital Appeal Writers
• Hospital Finance Associates

What is the presenter's background/expertise on this topic?

Internal Medicine Hospitalist involved in coding and documentation on both the payor and hospital-side for eight years. Recently, specialization in DRG Validation on the payor side.

Amarin Alexander MD MBA MA, CPC-A, CDEI, CIC, CPMA, CRC

About The Author

Amarin Alexander MD MBA MA, CPC-A, CDEI, CIC, CPMA, CRC

Dr. Alexander is a retired Hospitalist and a former Physician Advisor for a hospital system. He has worked in a variety of payor roles including Utilization Management and Risk Adjustment. He is Internal Medicine Board Certified and is also credentialed with AAPC, AHIMA, ACDIS and ABQUARP.  He currently works in DRG Validation for a payor.

Two ways to register for this event

Two ways to register for this event
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